Provider Demographics
NPI:1336742097
Name:BAKER, JOANNA L
Entity Type:Individual
Prefix:
First Name:JOANNA
Middle Name:L
Last Name:BAKER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5177 RASPBERRYBUSH CT
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43230-1081
Mailing Address - Country:US
Mailing Address - Phone:614-208-1290
Mailing Address - Fax:614-363-2459
Practice Address - Street 1:5177 RASPBERRYBUSH CT
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43230-1081
Practice Address - Country:US
Practice Address - Phone:614-208-1290
Practice Address - Fax:614-363-2459
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-17
Last Update Date:2020-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health